German researchers have been successful in ascertaining the difference between cancerous cells in regional lymph nodes and normal residual thyroid tissue following surgery.
Researchers at the University of Erlangen-Nürnberg have revealed that they achieved this breakthrough while studying the diagnostic value of molecular imaging in nodal staging of patients with thyroid cancer.
Describing their work in an article in The Journal of Nuclear Medicine, the researchers said that they used a hybrid single photon emission computed tomography-computed tomography (SPECT-CT) camera to determine and locate the spread of cancer cells to nearby lymph nodes.
According to them, the demonstration or exclusion of cancer spread (metastasis) in regional lymph nodes plays a major role in treating the disease since all patients with lymph node metastases are considered to be at high risk for recurrence.
During the study, the researchers administered radioiodine therapy to 57 patients, and, afterwards, a SPECT-CT camera was rotated around the patients at a variety of angles to capture where the radioactivity was occurring.
SPECT imaging can locate cells in the body that are not behaving normally, but does not provide the detailed, X-ray-like images that CT imaging can.
However, the hybrid camera used in the study was able to reveal both the malignant cell activity and the exact anatomical location.
"With SPECT-CT imaging, we were able to determine tumour spread much earlier than before. Earlier detection will lead to earlier individualized treatment of this potentially deadly cancer," said Dr. Daniela Schmidt, a co-author of the article.
According to the research team, this information led to a revision of the original diagnosis in 35 percent of the study participants. The images reclassified as benign six of 11 lesions that had been considered lymph node metastases and 11 of 15 lesions considered to be indeterminate.
"Our data suggest that SPECT-CT should be used as a routine procedure in DTC patients at the first radioiodine treatment. By upstaging or downstaging disease, this hybrid imaging tool may alter the management of more than one-third of patients with the disease," said Dr. Torsten Kuwert, another co-author.